"As the twig is bent, so grows the tree." A sign bearing these severe but hopeful words marks the entrance to Cooper Village, a residential treatment facility for teenagers along the rural northern edge of Omaha.

...Robert A. Hawkins, as a ward of the State of Nebraska, received extensive care at Cooper — private psychotherapy, family therapy, drug counseling — from 2003 to 2005.

It was his longest stop in a five-year journey through a maze of juvenile-services programs that began when he was 13 and was charged with making homicidal threats toward his stepmother.

His was hardly an idyllic childhood. Mr. Hawkins’s parents divorced when he was 3. Officials said that from that point, he lived with his father, Ronald Hawkins, who was in the Air Force, and his mother had little involvement in his life. Both parents remarried and eventually divorced again. A juvenile petition filed in 2002 listed Mr. Hawkins's father’s address but stated that his mother's whereabouts were unknown.

In May that year, after Mr. Hawkins threatened to kill his stepmother, he was admitted to the Piney Ridge Center in Waynesville, Mo. Court records show that by that September, he had been hospitalized twice for psychiatric problems, and doctors had diagnosed attention-deficit disorder, oppositional defiant disorder, a mood disorder and "parent/child relational problems."

When his military health insurance ran out, the elder Mr. Hawkins applied for his son to become a ward of the state. The boy moved in and out of foster care, in and out of school — last year, he eventually dropped out of high school — and through residential facilities, including Cooper Village.

Hawkins had been described earlier in the media as "depressed." I don't know the full extent of Hawkins' mental problems, but I said earlier that I felt there was more going on than just depression, and the article suggests that may well be the case. But the New York Times article also underscores a point I tried to make in the previous post.

But even with the intervention, said Denis McCarville, who runs Cooper Village, the state failed Mr. Hawkins.

"If this were a physical health issue — if he had leukemia — you would not say that as much as possible had been done," Mr. McCarville said. "This was not pursued. As you can see, there continued to be issues."

There continue to be issues alright.

When I heard about the Omaha shooting, my first question was: where did he get the gun? In the aftermath of the Virginia Tech shooting experts said that gunman Seung-Hui Cho's mental illness should have stopped him from purchasing a gun, because a Virginia court declared him to be a danger to himself and sent him for psychiatric treatment. And in November more mentally ill people were barred from buying guns, when the federal list doubled in size.

A federal list of mentally ill people barred from buying guns has doubled in size since the Virginia Tech shootings, and U.S. Attorney General Michael Mukasey encouraged more states Thursday to add information to the database.

In his first policy speech since taking over as attorney general early this month, Mukasey said states have now reported 393,957 mentally ill people to the federal database used to screen the backgrounds of potential gun-buyers. As of last July, three months after the Virginia Tech shootings, states had submitted only 174,863 names to the database.

Unlike Cho, Hawkins didn't purchase his weapon, but apparently got his gun from his father's house, saying that he was going to use it for "target practice." But that doesn't quite answer the question why anyone who knew this young man and his mental health history knew he had a gun and didn't do something to take it from him, if possible.

But maybe they just thought he was handling things better. That's one of the problems with mental illness. Like physical illnesses, mental illness cam sometimes metastasize while, to all external appearances, the person affected seems reasonably healthy. And like some physical illnesses, mental illness can be buried too deep and detected too late, and once detected may have spread too far to treat successfully.

Hawkins, is seems, received more treatment than most. But my guess is that further examination will reveal, as with Cho's undiscovered anxiety disorder following the VA Tech shooting, will show that Hawkin's had mental problems that had not been detected and treated and, as with the report after the VA Tech shootings, lives would have been saved if those mental health needs had been met.

And, as with the VA Tech report, recommendations to improve mental health services will be made. Whether those recommendations will be carried out, or whether they'll even be addressed before another Omaha shooting or VA Tech shooting happens. Is anybody's guess.

What's certain is that, a with any other illness, mental illness left untreated will result in disastrous consequences, for individuals, families, and communities.

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This is a really thorny issue. first you have his access to guns, that is not hard in this day and age. with all the Victim disarmorment laws restricting the rights of the potential victims to defend themselves there is no way to defend against people who obtain guns by illegal means.

Then there is the monitoring or the lack thereof of people on SSRI drugs. I have seen three instances where people on SSRI's have attacked family members, once it was me, my wife took out after me with a knife when disarmed she bit my left arm all the way to the bone. She had the first ever psychotic break. Over the years the doctors just put her on more psych meds with no regard for how they interact. She had 3 more psychotic breaks from 1995-2006. There are a lot of us who are old enough to remember these mass killings only happening once every other year or so. Now it seems it's four to six times a year.

I still have the physical and emotional scars from that night on April 30 1994.

There are a lot of information on the web in regards to the mis application of SSRI drugs all anybody need do to find it is google Ann Blake Tracy

Sometimes the treatment hurts more than it helps. I found out I was bipolar after I went to get help for the most severe depression I'd ever had. They put me on Wellbutrin.

If you give a bipolar person an anti-depressant without a mood stabilizer, it causes mania. And it did. I'd never experienced a real mania and had no idea what was going on; I just knew it was horrible and I thought I was losing my mind (of course, I was!). I lost my job when I jumped a counter to beat up a customer for calling the guy I was working with a "Spic." As I'm usually Mr. Non-Violence, I left work and went to the doctor's office and demanded they reconsider.

in the old days (listen to me) people were encouraged to find the strength from within to deal with these issues. I hear people say society is so complex these days that people can't cope without drugs I am a little suspicious of that statement. While i see the possibility environmental factors may influence the mental stability of many folks today, i still feel it's possible to cope with a lot of these issues cognitively. people are less willing to use this route because it is labor intensive and requires the subject to be honest with themselves to a fault. I do have some experience in this as in other threads i have discussed my nearly 12 years with dealing with clinical depression and the cognitive approach i used to master Not Control my mood swings.

for some people drugs are the only answer, however that shifts the burden of labor over to doctors to perodically interview and monitor the subject's mental health. One thing that happens with these drugs is the brain compensates for the presents of these drugs and those drugs have to be ether adjusted in dossage or replaced with a different drug in order to maintain balance.